rev - maine.gov · web viewthis means that when a change is reported by the household during the...

DEPARTMENT OF HEALTH AND HUMAN SERVICESOFFICE FOR FAMILY INDEPENDENCE

FOOD SUPPLEMENT PROGRAM

CERTIFIED HOUSEHOLDS

R 07/17 - 195A 7 U.S.C. §§ 2020(s)(1) and (s)(3)(B) Section: FS-666-5

TRANSITIONAL FOOD ASSISTANCE (TFA)

Transitional Food Assistance (TFA) benefits are a fixed monthly amount of Food Supplement benefits that are provided for up to five months to certain families whose TANF cash assistance has ended. TFA eligibility is based on the TANF closure so the household must have received TANF or TANF/PaS cash assistance within the past 30 days and Food Supplement Program benefits within the past 60 days to be considered for TFA eligibility. The household does not have to lose eligibility for regular Food Supplement benefits to become eligible for TFA, however, the household cannot receive TFA and regular Food Supplement benefits at the same time.

Eligibility for Transitional Food Assistance (TFA)

All included members in an open Food Supplement household, that includes at least one member from a TANF financial assistance group at the time the TANF closes, are eligible for TFA.

Approved TANF closure reasons are:

1. Gross or net income over limits;or2. Increase in work hours, transitional services.

Households eligible for TFA will receive a TFA Start Letter, which contains information about who is eligible for TFA, the amount of the benefit, how the benefit was determined, and the length of the TFA period. The letter will also explain the process for reporting household changes for those receiving TFA. Households will be notified that they are not required to report any changes in circumstances until the time that they must apply for recertification. Finally, the letter will notify families that their benefit allotment can be changed if the household experiences a decrease in income, an increase in expenses or an increase in household size that could lead to a higher Food Supplement allotment.

Households are not eligible for TFA if TANF cash assistance closed in part or solely due to any of the following:

1. a sanction, being a fugitive felon, or Intentional Program Violation;2. a transfer of assets or property to qualify for assistance;3. failure to cooperate with quality control or child support;4. failure to provide verification required to determine eligibility;5. not residing in Maine;6. a case head has left the household.




R 07/17 – 195A 7 U.S.C. §§ 2020(s)(1) and (s)(3)(B) Section: FS-666-5

Eligibility for Transitional Food Assistance (TFA) (continued)

Households in which all members are ineligible for the Food Supplement Program are also ineligible for TFA.

Individuals ineligible or excluded from the Food Supplement Program at the time that TFA is initially determined will remain ineligible for the duration of the TFA period.

Determining the Transitional Food Assistance (TFA) Benefit Allotment

The TFA benefit amount is based on information already known at the time the TANF ends. No further contact is required with the household until the end of the TFA period.

The TFA benefit amount is determined by using the Food Supplement Program budget for the last month that TANF cash was issued and deducting the TANF grant that the household is no longer receiving.

The resulting net income is used to calculate the TFA benefit amount.

The TFA benefit amount is frozen for the duration of the TFA period regardless of any changes to the household’s circumstances. See Transitional Food Assistance Requirements and Changes During the Transitional Food Assistance (TFA) Period below.

EXCEPTIONS: Only under the following circumstances are TFA benefits recalculated during the TFA period:

1. federally mandated updates to Food Supplement Program allotments and deductions in October;

2. recoupment; and

3. if a member of an TFA household moves out and either reapplies on their own or is reported as a new member in another Food Supplement household.

Transitional Food Assistance (TFA) Period

The TFA benefit period begins the first month following the last month TANF financial assistance was received and continues for five consecutive months, unless during the TFA period the household:

1. opens for TANF cash;2. reapplies for regular Food Supplement Benefits; or3. requests that TFA close.




R 07/17 – 195A 7 U.S.C. §§ 2020(s)(1) and (s)(3)(B) Section: FS-666-5

Transitional Food Assistance (TFA) Period (continued)

The recertification period for Food Supplement Program will be reset to match the last month of TFA at the time the household is found eligible for TFA. See FS-666-8, Shortening a Certification Period.

Households will be mailed a special review form the end of month four of the TFA period. Households must recertify for regular Food Supplement benefits by completing the review form during TFA month five to have eligibility for regular Food Supplement benefits redetermined. During the recertification, all changes that were reported during the TFA period, and any new information, will be used to determine ongoing Food Supplement Program eligibility. If the household fails to complete and submit the review form or reapply, TFA automatically terminates on the last day of month five.

Transitional Food Assistance (TFA) Work Requirements

There are no work registration requirements or ABAWD work requirements during the TFA period.

Changes During the Transitional Food Assistance (TFA) Period

If the household only receives TFA, and is not open for another assistance program, the household has no reporting requirements. If the household is open for other programs in addition to TFA, the household must continue to report all changes as required by those programs.

Since TFA benefits are frozen and cannot be altered during the TFA period, any changes acted upon for other programs will not impact the TFA benefit amount. See EXCEPTIONS on previous page.

If a household experiences a decrease in income, an increase in expenses, or an increase in household size, the household’s benefits could potentially be higher if the household stopped TFA and requested regular Food Supplement benefits. Because benefits are frozen during the TFA period, the household must reapply for regular Food Supplement benefits to have the household’s benefit allotment amount changed.

Terminating Transitional Food Assistance (TFA)

TFA will automatically end under the following circumstances:

1. the household opens for TANF cash;

2. the household reapplies for regular Food Supplement benefits. See Changes During the Transitional Food Assistance (TFA) Period above; or

3. the household fails to complete and submit the review form during month five of the TFA benefit.




R10/17 - #202A CFR 273.12/ 7 CFR 273.24 Section: FS-666-6Page 1

Changes during the certification period

All certified households must report certain changes as follows:

1. Changes in income (as specified below) within 10 days of receipt of the first payment associated with the change;

2. Changes in assets, and other circumstances within 10 days of the date the change becomes known to the household.

The agency shall take action no later than 10 days from the date the change is reported.

All certified households must report the following:

1. Changes in the sources of income, including starting or stopping a job or changing jobs, if the change in employment is accompanied by a change in income.

2. Changes of more than $50 in the amount of gross monthly unearned income. This does not include vendor payments (i.e. General Assistance) or reimbursement in the form of vendor payments. Reimbursements paid to the household in the form of cash are reportable. Changes to TANF benefits and child support pass-through and gap payments do not have to be reported.

3. All changes in household composition, such as the addition or loss of a household member.

NOTE: An individual cannot participate as a member of more than one household in any month – this includes those who move in with someone else and those who establish their own household, even when the advance notice requirement prevents the individual from being removed from the prior household before the next allotment is issued.

4. Changes in residence and the resulting change in shelter costs.

5. The acquisition of a licensed vehicle not totally exempt under FS-333-3.

6. When cash on hand, stocks, bonds, and money in a bank account or savings institution reach or exceed the current asset limits under FS-333-3.

7. Changes in the legal obligation to pay child support.

8. For able-bodied adults without dependents (ABAWDS) subject to the time limit under FS-111-7, any changes in work that causes hours to drop below 20 hours per week.




R10/17 - #202A 7 CFR 273.12/ 7 CFR 273.24 Section: FS-666-6Page 2


Changes that are reported, whether as part of recertification, as mandatory reporting or as a voluntary report will be acted upon in the following manner:

Households which are applying for initial or recertification must report all changes related to eligibility and benefits at the certification interview.

Advance notice of adverse action is required when the change results in a reduction or termination of benefits within the certification period.

Verification of reported changes: The same verification procedures that are used for initial application will be used in all subsequent eligibility and benefit level decisions.

NOTE: If any responsible member provides information in writing, requests that the action take effect immediately, and signs that statement, the action will be taken immediately.

I. All factors of the certification period shall be determined prospectively.

A. If ineligible, close the case and give advance notice of adverse action.

EXCEPTION: If the household is expected to be ineligible for only one month, suspend the case and give advance notice of adverse action.

B.If eligible, benefit level shall be determined based upon anticipated income and circumstances.

C.If the change results in decreased benefits, give advance notice of adverse action and decrease the benefits.

D.If the change results in increased benefits or no change in benefits, take necessary action and notify the client. Increased benefits shall be made effective for the month following the report month in which the change is reported.





Unclear Information

During the certification period, information on household circumstances may be received that requires clarification or verification in order to determine a household’s continued eligiblity for benefits. Unclear information can be either not verified or verified but still requiring additional information to act on it. Unclear information will be processed as follows:

1. If the unclear information is received outside of the review process and is less than 60 days old from the current month of participation and would have met the requirements for a reportable change, as stipulated on page 1 of this section, then a request for contact letter shall be sent which informs the household about the required verification needed to clarify household circumstances, with a 10-day time frame in which to respond.

Failure to respond will result in a notice of adverse action to close the case and advise the household of the requirement to submit a new application if it wants to continue to participate in the Food Supplement Program.

2. If the unclear information significantly conflicts with the information used by the Office for Family Independence (OFI) staff to determine eligibility at the time of certification, then a request for contact letter shall be sent which informs the household about the required verification needed to clarify household circumstances, with a 10-day time frame in which to respond.


3. If the unclear information is received as a result of a data match with the prisoner verification system or the deceased matching system, then a request for contact letter shall be sent which informs the household about the required verification needed to clarify household circumstances, with a 10-day time frame in which to respond.


4. If the unclear information does not meet the criteria for numbers 1 or 3, above, OFI staff will not act on the information or require the household to provide any verification related to this information until the next recertification.






I. State Mandated Supplements

A. When a change is reported by the household, and it would have resulted in a benefit increase for the month in which it is reported had the allotment not already been authorized, a supplemental allotment shall be issued. The amount shall be calculated based upon the difference between the amount already authorized and the amount the household would have received based upon the circumstances in the month the change is reported.

NOTE: This means that when a change is reported by the household during the certification period, a determination of whether or not a supplement is required must be made based solely on the circumstances in the month in which the change is reported. It is conceivable that a reported change could result in a decrease in next month's benefits and a supplement for this month.

B. Some examples are:

1. TANF/PaS mother and one child with no income other than TANF/PaS reports an additional child in March. April's TANF/PaS is increased but the TANF/PaS supplement date is believed to be April. The Food Supplement benefit supplement for March would be based on a household of three and the March TANF/PaS check amount which was for two. April's Food Supplement benefit would be based on a household of three and the anticipated April TANF/PaS benefits which will be for three. If the TANF/PaS supplement will be received in March it would be counted in the calculation of the Food Supplement benefit supplement.

2. In March, a Food Supplement household of four reports the loss of the member who was the sole source of income. Since the member has already participated, his income cannot be removed until April. March benefits will be based upon a household of four and the income of each member and the March circumstances of the remaining household members. There would be no supplement for March, and April benefits would be based upon a household of three; its income, and circumstances.




10/17 - #202A CFR 273.12 / 7 CFR 273.24 Section: FS-666-6Page 5


3. A Food Supplement household of five reports early in March that working member is laid off; will receive 1 pay check and one UIB check in March. The benefit supplement is based upon a household of five, the total of the earnings plus the one UIB check, and the other March circumstances unless otherwise indicated. April benefits shall be based upon household anticipated circumstances.

4. A Household reports in May that a working member will be laid off one day in May. Full time work will resume in June. The May supplement is based upon one day loss of pay, household composition and circumstances in May. June benefits will be the same as May's regular allotment, provided no other changes are anticipated.

C. Under no circumstances should a supplemental allotment be calculated based simply upon the difference between "this month's allotment compared to next month's allotment".

D. Supplements shall be authorized not later than 5 days after the change is reported. Households are entitled to the supplement whether or not the change is reported within 10 days of its occurrence. They are also entitled to the supplement when the change is reported during the redetermination process.




#164AR02/09

TANF Reference: CFR 273.12 / 7 CFR 273.24 Section: FS-666-6Page 6



Different II. State Mandated Supplements

A. When a change is reported by the household, and it would have resulted in a benefit increase for the month in which it is reported had the allotment not already been authorized, a supplemental allotment shall be issued. The amount shall be calculated based upon the difference between the amount already authorized and the amount the household would have received based upon the circumstances in the month the change is reported.

NOTE: This means that when a change is reported by the household during the certification period, a determination of whether or not a supplement is required must be made based solely on the circumstances in the month in which the change is reported. It is conceivable that a reported change could result in a decrease in next month's benefits and a supplement for this month.

B. Some examples are:

1. TANF/PaS mother and one child with no income other than TANF/PaS reports an additional child in March. April's TANF/PaS is increased but the TANF/PaS supplement date is believed to be April. The Food Supplement benefit supplement for March would be based on a household of three and the March TANF/PaS check amount which was for two. April's Food Supplement benefit would be based on a household of three and the anticipated April TANF/PaS benefits which will be for three. If the TANF/PaS supplement will be received in March it would be counted in the calculation of the Food Supplement benefit supplement.

2. In March, a Food Supplement household of four reports the loss of the member who was the sole source of income. Since the member has already participated, his income cannot be removed until April. March benefits will be based upon a household of four and the income of each member and the March circumstances of the remaining household members. There would be no supplement for March, and April benefits would be based upon a household of three; its income, and circumstances.




R02/09#164A

TANF Reference CFR 273.12/ 7 CFR 273.24 Section: FS-666-6Page 7



3. A Food Supplement household of five reports early in March that working member is laid off; will receive 1 pay check and one UIB check in March. The benefit supplement is based upon a household of five, the total of the earnings plus the one UIB check, and the other March circumstances unless otherwise indicated. April benefits shall be based upon household anticipated circumstances.







R07/06#149A

AFDC Reference CFR 273.12 / 7 CFR 273.24 Section: FS-666-6Page 8



3. A Food Supplement household of five reports early in March that working member is laid off; will receive 1 pay check and one UIB check in March. Supplement is based upon a household of five, the total of the earnings plus the one UIB check, and the other March circumstances unless otherwise indicated. April benefits shall be based upon household anticipated circumstances.







R1092TANF or PaS Reference CFR 273.12(e) Section: FS-666-7


Mass Changes

Same GENERAL RULE - Certain changes are initiated by the State or FederalChap. I, Sec. C, government which may affect all or most of the caseload. These changes page 1 include, but are not limited to:

1. adjustments in the Thrifty Food Plan.

2. adjustments in the standard deduction.

3. adjustments in the shelter/dependent care deduction.

4. adjustments in the income eligibility standards.

5. periodic adjustments to TANF or PaS payments.

Advance notice of adverse action is not required when a household's benefits are reduced or terminated as a result of a mass change. The household shall receive adequate notice not later than five days before benefits would normally be received.

*EXCEPTION: Adverse actions resulting from computer to computer matching concerning mass changes to Federal benefits, other than Social Security and SSI, require an advance notice of 30 days.




R 04/17 - #195A 7 CFR 273.10(f) Section: FS-666-8Page 1


CERTIFICATION PERIODS

GENERAL RULE - Establish a definite period of time which the household shall be eligible to receive Food Supplement benefits. At the expiration of each certification period entitlement to benefits ends. At initial application, the first month of the certification period shall be the month of application. Certification periods shall conform to calendar months and shall not be more than twelve (12) months.

NOTE:Food Supplement Program (FSP) applicants and recipients receiving TANF/PaS and MaineCare shall be assigned a common re-determination period based upon FSP criteria. Categorically eligible TANF/PaS households shall have their FSP benefits terminated for failure to complete a re-determination even though they continue to receive TANF/PaS or SSI benefits. When TANF/PaS benefits are terminated within the certification period, and the agency does not have sufficient information to determine the effect upon FSP eligibility and benefit level, the following actions shall be taken:

Wait until it is certain that the TANF/PaS benefits will be closed for at least one month.

Unless the certification period expires by the end of the following month, send a notice of expiration which informs the household that its certification period will expire at the end of the month following the month the notice of expiration is being sent, and that its certification period is expiring because of changes in its circumstances which may affect its FSP eligibility and benefit level.

1. All households shall be assigned a twelve (12) month certification period.




Rev. 03/08 - 156A 7 CFR 273.10(f) Section: FS-666-8Page 2


SHORTENING A CERTIFICATION PERIOD

There are only three basic instances when the State can shorten a certification period:

1. When the State received information which indicates the household is ineligible,

2. When a household is found eligible for Transitional Food Assistance (TFA) and the recertification month is pushed back to match the last month of TFA, or

3. When the household does not cooperate in clarifying its circumstances.

For #1 & #3 only, a contact letter must be sent giving ten (10) days to respond. If the household does not respond, or responds and refuses to provide information, a notice of adverse action is sent for termination.




10/05 Rev. #145A7 CFR 273.10, 273.14 Section: FS-666-9

page 1


Redeterminations

GENERAL RULE - The right to participate ends with the last day of the certification period. Each household shall be provided a notice of expiration by the beginning of the last month of certification. Benefits shall not be continued beyond the certification period, unless eligibility has been redetermined. To be redetermined, the household must submit asigned form and be interviewed face-to-face or by telephone. Advance notice of adverse action is not required when benefits change from one certification period to another.

Timely Redetermination

If the household timely files the recertification form, attends any required interview scheduled on or after the date the form was timely filed, and submits all necessary verification within the agency's time frame, the agency shall approve or deny the recertification and notify the household of its determination by the end of the household's current certification period. In addition, the agency shall provide the household an opportunity to participate by its normal issuance cycle in the month following the end of its current certification period.

To be considered timely filed, the agency must receive the household's recertification form by the 15th day of the last month of the certification period.

When a face-to-face interview is required, the agency shall schedule the interview on or after the date the application was timely filed if the interview has not been previously scheduled.

When any required verification is requested, the household must be allowed at least 10 calendar days to provide this in order to ensure its rights to uninterrupted benefits.

Any eligible household not determined eligible in sufficient time to participate by its normal issuance cycle, due to the time period allowed for submitting any missing verification, shall receive an opportunity to participate within 5 working days after the household supplies the missing verification.




Rev. 12/14#188A

7 CFR 273.10, 273.14, 273.2(f)(4)(i) Section: FS-666-9page 2


Redeterminations

Untimely Redetermination

The household shall lose its right to uninterrupted benefits for failure to file the recertification form by the 15th day of the last month of the certification period, attend any required interview scheduled on or after the 15th day of the last month of the certification period, or to submit all necessary verification within the time frame established by the agency as long as the time frame elapses after the 15th day of the last month of the certification period.

If the household loses its right to uninterrupted benefits due to such failures but is otherwise eligible after correcting such failures, the agency shall provide benefits within 30 days after the application was filed or within 10 days of the date the interview was completed or the required verification is provided, whichever is later.

If the household does not file the recertification until after the end of the previous certification period, the allotment to be issued for the initial month of recertification shall be prorated from the date of the application, using the “Table of Percentages for First Month Benefit” chart at FS-555-7, page 2.

DenialsDenials shall be completed either as soon as the household fails to appear for an interview or fails to submit verification within the required time frame, or by the end of the current certification period or within 30 days after the date the application was filed as long as the household has had adequate time for providing the missing verification.

Verification - Verify the following:IncomeAllowable medical expensesAllowable legally obligated child support payments, when any changes in the legal obligation to pay

child support, the obligated amount, and the amount paid are reported or the information is questionable

Utility expenses, when household chooses actual expenses Separate household status, if claimed by the household

Separate household status and other information which is questionable shall be verified:

- Eligibility workers shall verify factors affecting the composition of a household, if questionable, including but not limited to instances where documentary evidence presented appears to be outdated, inaccurate, or potentially falsified




- Acceptable verification shall not be limited to any single type of document and may be obtained through the household or other source. Whenever the documentary evidence cannot be obtained, is questionable, or is insufficient to make a firm determination of eligibility or benefit level, the eligibility worker may require collateral contacts or home visits.




Rev. 04/09#165A

7 CFR 273.10, 273.14 Section: FS-666-9page 3

Notices - Participating households which meet the "timely redetermination" time standards listed above shall be mailed an adequate notice of the agency action by the end of the household's current certification period.

Participating households which do not meet the timely redetermination time standards shall be mailed an adequate notice of agency action within 30 days after the date the redetermination form was filed.




R10/99#107A



TANF Reference CFR 273.17 Section: FS-666-10Page 1


Different Restoration of Lost Benefits Chap. I, Sec. F

GENERAL RULE - Do not restore benefits more than twelve (12) months prior to the month the agency becomes aware of the underpayment or is notified of the reversal.

When an underpayment is identified, take action to restore benefits when:

- the underpayment was caused by the agency;

- a disqualification for intentional program violation is reversed, or special instructions state that a household is entitled to a restoration of lost benefits.

A household is entitled to restored benefits, even if it is not currently receiving FS.

Installments may be made to restore lost benefits. An accounting system for documenting entitlement to restored benefits and for recording the balance must be maintained.

A fair hearing may be requested when the client is dissatisfied.

In order to restore benefitsDetermine the time period to be covered in the restoration.

1. Regardless of the time period of lost benefits, restoration cannot cover more than a twelve (12) month period. Restoration may be made

- back to the date of application when erroneously denied.




- back to the first month that benefits were not received when benefits were erroneously terminated.

- for the months the household was underpaid.




R10/99#107A

TANF Reference CFR 273.17 Section: FS-666-10Page 1a

The difference between what the household received and what it should have received equals the amount to be restored.

2. Establish eligibility for each month's benefit separately.




R0791TANF or PaS Reference CFR 273.17 Section: FS-666-10


Restoration of Lost Benefits

3. Subtract any amount owed the agency due to any previously established claim for overpayment, regardless of cause of overpayment.

4. If the household's membership has changed, restore the benefits to the household containing the majority of the household members at the time the error occurred. If this cannot be determined, restore benefits to the person who was the head of household at the time of the error.

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